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Contact Information

TRACY L ALLEN, PA
101 RIVERSTONE VIS
SUITE 111
BLUE RIDGE, GA30513-6648
 Phone: 706-946-4200
 Fax: 706-946-4243
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for TRACY L ALLEN · (Female)

NPI Number 1124036520
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 08/03/2006
Last updated 06/21/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 005894
  • ME License # PA-440
  • GA Medicaid 003100897C
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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